Mun-Keat Looi

Another expert from the US Centers for Disease Control and Prevention (CDC) has resigned in protest at Robert F Kennedy Jr’s purge of its advisory committee on immunisation practices.1 Fiona Havers cited loss of confidence in the scientific objectivity of vaccine policy.2The committee’s purge and staff reductions have sparked widespread concern about the erosion of US immunisation efforts.3 Writing in JAMA , all 17 former members of the committee decried their abrupt dismissal and expressed concern about transparent, evidence based guidance for immunisation policies.4Similarly, members of the CDC’s healthcare infection control practices advisory committee, also writing in JAMA , condemned the termination of their 34 year old panel,5 which provided infection prevention guidelines and informed regulations and clinical practice. Its dissolution risks undermining decades of progress in healthcare associated infection control, jeopardising patient safety and healthcare quality, the members said. They called for the reestablishment of an independent advisory body to …

Vinay Prasad—the controversial head of vaccine regulation at the US Food and Drug Administration (FDA)—has been named FDA chief medical and scientific officer.1 Traditionally separate roles, his new position—in addition to his heading the Center for Biologics Evaluation and Research—grants authority across all regulatory centres and expands his influence as a top adviser to FDA commissioner Marty Makary.Prasad, a haematologist and oncologist, is a longtime critic of the FDA and is known for his negative views of doctors working with the pharmaceutical industry as well as the way clinical trials are conducted. His first appointment to the FDA in May—in a key role that regulates vaccines among other medical products—was controversial given his lack of experience in government and the fact that he was replacing …

The first meeting of the US vaccine advisory committee since all previous members were fired is attracting controversy before it has even begun.On 24 June, two days before the Centers for Disease Control and Prevention (CDC) advisory committee on immunisation practice (ACIP) was to meet, Senator Bill Cassidy called for the meeting to be postponed1 citing the inexperience and potential biases of new members appointed by health secretary Robert F Kennedy Jr, who replaced all 17 previous committee members earlier this month.Cassidy, who previously supported Kennedy’s confirmation, questioned the panel’s legitimacy and its ability to evaluate vaccines like mRNA covid-19 jabs.The agenda for the meeting includes2 items on thimerosal containing flu vaccines and measles, mumps, and rubella vaccination in children under 5. An additional third day of the meeting on 27 June was also announced, with no agenda published publicly.Separately, the Center for Infectious Disease Research and Policy’s vaccine integrity project is emerging as one of the leading contenders for an independent vaccine advisory panel3 in response to Kennedy’s ACIP replacement.4The Trump administration plans to delay and reassess a 2024 Environment Protection Agency (EPA) ban on chrysotile asbestos, potentially …

The origins of SARS-CoV-2 remain unsolved, concludes the full report from the World Health Organization’s Scientific Advisory Group for the Origins of Novel Pathogens (SAGO).1Despite more than three years of investigation, the 27 member expert panel said that several hypotheses remain viable, because of missing data—particularly from China.2“As things stand, all hypotheses must remain on the table, including zoonotic spillover and lab leak,” said WHO’s director general, Tedros Adhanom Ghebreyesus. “We continue to appeal to China and any other country that has information about …

The Marmot review’s author spoke to the WIRED Health conference about “proportionate universalism,” racism, and a million UK children living in destitution. Mun-Keat Looi reports### BiographyMichael Marmot is professor of epidemiology at University College London, director of the UCL Institute of Health Equity, and past president of the World Medical Association.At the UCL Department of Epidemiology and Public Health he set up and led a number of longitudinal cohort studies on social gradients in health: the Whitehall II Study of British civil servants, investigating explanations for the striking inverse social gradient in morbidity and mortality; the English Longitudinal Study of Ageing; and several international research efforts on the social determinants of health. He also chaired the Commission on Social Determinants of Health, set up by the World Health Organization in 2005.At the request of the British government Marmot conducted the Strategic Review of Health Inequalities in England, which published Fair Society, Healthy Lives (also known as the Marmot review) in February 2010. A follow-up report was published in 2020.The Marmot review included …

Axios reports that the Trump administration has terminated around $20m (£14.6m; €17m) in federal subscription contracts with the scientific publisher Springer Nature, citing concerns over content and political bias. The US Justice Department previously questioned the publisher’s editorial stance and ties to China. According to Axios, all Springer Nature contracts are now inactive, with billions more in scientific journal funding under review.1In an interview on The Tucker Carlson Show ,2 US health secretary Robert F Kennedy Jr said he had assembled a team to explore expanding the National Vaccine Injury Compensation Program, aiming to include covid-19 vaccine injuries and extend the statute of limitations. Such changes would require congressional approval. Critics have noted …

US president Donald Trump’s major economic bill will be signed into law on 4 July, after a week of intense debate saw it narrowly passed by both the Senate and House of Representatives. Estimates say that nearly 12 million Americans could lose their health insurance as a result.The 940 page One Big Beautiful Bill Act1 makes cuts estimated to be as much as $1tn (£732bn; €849bn) over 10 years to spending for healthcare and cuts tax credits for clean energy enabled by President Joe Biden. The bill makes permanent the tax cuts enacted in Trump’s first term, while greatly increasing spending for defence and the deportation of undocumented immigrants. It also increases US debt and the US debt limit, which can have long term effects on the economy.Major cuts will be made to Medicaid, the federal health insurance programme for people on low incomes. The impartial Congressional Budget Office (CBO) released figures2 projecting that as many as 11.8 million Americans could lose health insurance coverage over the next 10 years as a result. Of those, 1.4 million are without “satisfactory immigration status” the CBO said. Medicaid currently insures 71.3 million …

Democrat mayors from Baltimore, Chicago, and Columbus, Ohio, have filed a lawsuit1 against the Trump administration’s rollback of access under the Affordable Care Act, alleging that the changes will increase the number of uninsured Americans. The new rules shorten enrolment periods, impose stricter income verification, and add fees for autorenewals. Around two million people may lose their cover. Two advocacy groups also joined the suit, citing harm to public health and a lack of proper public input.The health secretary, Robert F Kennedy Jr, approved two long pending vaccine recommendations from the Centers for Disease Control and Prevention (CDC)2: GSK’s MenABCWY meningococcal vaccine for at-risk people aged 10 and over and healthy people aged 16-23; and expanded vaccination against respiratory syncytial virus in high risk adults aged 50-59 who are using GSK, Pfizer, or Moderna products. The recommendations were made before Kennedy dismissed and replaced the CDC’s vaccine advisory committee …

Science reported that the National Institutes of Health (NIH) director, Jay Bhattacharya, dismissed all members of the agency’s top external advisory body, the Advisory Committee to the Director (ACD).1 Asked to comment, the Department of Health and Human Services—the NIH’s parent agency—told The BMJ , “On background: new NIH ACD members are being selected, and the process will be completed in the coming weeks . . . The NIH director provides membership recommendations, and final selections for ACD membership remain—as they always have—with the secretary of health and human services.” Critics, including former members, fear that the move will lead to politically motivated appointments aligned with the views of the health secretary, Robert F Kennedy Jr.The Food and Drug Administration (FDA) fully approved Moderna’s covid-19 vaccine, Spikevax,2 for children aged 6 months to 11 years with at least one medical condition that increases their risk of severe illness. This is the first full approval of …

Gillian Leng led NICE for 20 years and now serves as president of the Royal Society of Medicine. Her landmark review into physician and anaesthesia associates (PAs and AAs) proposes a new direction for their integration in the NHS.1 Here, she speaks to BMJ editor in chief Kamran Abbasi about what the evidence showed, how she approached the task, and what must happen nextGillian Leng: “I wanted it to be based on the best available evidence. I wanted us to be comprehensive in looking at that evidence base, informed as much as it could be by engagement with all the relevant groups: the physician associates and anaesthesia associates themselves, the doctors, patients and their families, and managers, so very, very comprehensive. I think that’s the most important thing to emphasise.”“It was sadly not as helpful as it might have been. It didn’t provide a definitive answer. It was limited in terms of the quality—and in terms of most quality classifications that were used it was either low or very low quality. It was limited in terms of the scope that it covered and generally inconsistent. For instance, in the evidence base in secondary care there was nothing for anaesthesia associates. In terms …